Provider Demographics
NPI:1376036798
Name:FREEL, KARA LYNN (COTA)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:LYNN
Last Name:FREEL
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 SUSAN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-2190
Mailing Address - Country:US
Mailing Address - Phone:810-336-7077
Mailing Address - Fax:
Practice Address - Street 1:101 WALNUT LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4943
Practice Address - Country:US
Practice Address - Phone:931-381-3112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3038224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant